As married couples get lax on birth control, accidental pregnancies aren't a thing of the past

By Robyn Monaghan

Contributor

54 percent of married women 40-44 years reported sterilization
operations in 2002.

51 percent of pregnancies among women 40 years and older are
unintended.

38 percent of women have experienced an unplanned birth by the
time they reached 40-44.

1/4 (at least) of pregnancies among married women are
unintended.

1 in 20 American women has an unintended pregnancy each
year.

Source: National Survey of
Family Growth

Dr. Christopher Olson closes his eyes and plops a finger on a
page in his appointment book.

Odds are, he predicts, he'll hit the name of a woman who is
expecting when she least expects it-years after she thought her
childbearing days were history.

In an age where birth control comes in a patch and contraception
is a unit in high school health class, you might think the "oops
baby" is a phenomenon that died out when our moms hit menopause.
Not so. The late-life pregnancy is alive and well, born again from
the belly of "temporary birth control" methods that fail, Olson
says.

"I see it many, many times a week," says Olson, a practicing
OB-GYN and president of the Women's Center for Health in
Naperville.

More than half, 51 percent, of pregnancies among women over 40
are unintended, according to figures from the National Survey of
Family Growth, compiled by the U.S. Department of Health and Human
Services.

For Sheri Vodnik, a day care operator in Aurora, a fourth
pregnancy would have been a catastrophe, she says. Remembering the
struggles her family had with a brother and a sister who were seven
and eight years younger than the first two siblings, she was
determined not to repeat the pattern.

Shellie, now 30, was born even after her mother believed she was
pregnancy-proofed.

"In that way, it's kind of cool, because my mother had her tubes
tied and I came through anyway," she says. "I was meant to be."

Now, with two much older sisters, Mertes, who also does home day
care in Aurora, feels like she has three moms. But, as a little
girl, being the way-baby sister was about getting chased out of Big
Sissy's room, always being the nuisance, not getting invited on
drives with teenage sisters.

"Whether you've been in a family with an 'oops' baby, you have a
friend who's had an 'oops' baby or you just plain old don't want
one, it's something couples should think about before it happens,"
says Vodnik, who is 38.

Surprise!

Jill Malan calls 3-year-old Keith her "surprise baby." Through
years as a maternal health nurse at Rush Hospital, Malan had worked
with dozens of women who turned up pregnant when their older
children were in high school or college. Then, at 42-when her kids
were 5 and 7-she learned she was adding another bady to her
brood.

The Malans had given away all their nursery things-the crib, the
high chair, the stroller. She and her husband, Bill, had finally
made it to the point where they could enjoy taking the kids to a
restaurant and on vacations.

"We were thinking 'don't tell us we have to get back to babies
again,'" Malan says. "I can't tell you that initially it was
joyous."

Bill faced the new addition to the family with dogged
optimism.

"There's a positive side to everything," he quips. "By the time
I was done changing their diapers, they'd be old enough to change
mine."

Dexter and Leah Malan, now 10 and 8, were the most overjoyed
members of the family when they heard they were getting a baby
brother. But the siblings' delight dimmed to dismay when they found
the clan no longer could take off for the zoo in the afternoon.
Baby's nap time. And summer vacation? Maybe next year.

"It wasn't nearly as wonderful as they thought it was going to
be," Jill Malan says. "Having a baby really put a damper on what we
were able to do."

The Malans had waited until they were older to start their
family. When she found out she was expecting Keith, Jill was 42 and
Bill was 50.

"We thought 'How are we going to do this? We'll be nearly 70 by
the time this baby leaves for college," she says.

They reworked their retirement plans. They bought new baby
furniture and opened a new college savings account, which promptly
plunged in value with the sinking economy, Bill says.

Risky business

Jill and Bill, who live in Chicago's Little Italy, worried about
the complications and risks that come with pregnancy over 35. The
chances of genetic abnormality like Down's syndrome and miscarriage
are far higher for late-in-life pregnancies, Olson says. Still,
more than half of the women in his office are in their late 30s and
40s, he says.

"Since the risks of miscarriage are over 20 percent, a lot of
women just go ahead with the pregnancy and let nature take its
course," he says.

Those whose pregnancy goes full term find it's much tougher for
an older woman to tolerate the discomforts of pregnancy. Women with
other conditions that creep up with age, like diabetes and high
blood pressure,
find their bodies taxed further while carrying a baby.

"Almost every medical condition is amplified exponentially with
pregnancy over 40," Olson says. "It's just physically harder to be
human incubator when you're older."

The Malans opted for the full battery of prenatal
tests-amniocentesis, blood tests. They lucked out. Jill delivered a
healthy baby with no complications through a normal delivery.

But carrying her last baby was far more grueling than her first
two, Jill says. Though she dropped down to part-time nursing, she
felt overwhelmingly exhausted.

"I was so tired, there just seemed to be no end to how tired I
was," she says.

Honeymoons and history

The Malans relied on occasional at-the-moment birth control.
Like many middle-aged couples, they grew lax in pregnancy
prevention.

"We'd been married 16 years,' Bill Malan says. "This was no
honeymoon."

For parents who are certain their families are complete, Olson
is prescribing Essure, a new micro-insert for permanent birth
control. In a noninvasive procedure, a tiny insert goes into
fallopian tubes. In about three months, tissue grows into the
Essure micro-inserts to form a permanent barrier to pregnancy.

"The most important aspect is prevention," Olson says. "For
those who don't want to have incisions and general anesthetic for
tubal ligation or take sex steroids like birth control pills, this
is a great new option."

Sheri Vodnik found it cheaper-insurance usually pays for the
insert-and less painful than a vasectomy would have been for her
husband. She felt virtually no discomfort and did not miss any
intimate time with her husband, Jeff, after her last pregnancy.

Bill Malan, now in his early 50s, extols the joys of
later-in-life parenthood. When he shows up, gray hair and all, to
pick up his clan from school, Jill supposes folks figure he's their
grandpa.

"Being an old parent is cool," he says. "You're more able to
appreciate the simple things like the pitter patter of little feet
and that full, deep laugh."

Since Keith, Bill has had a vasectomy.

"With any luck, I'll be senile by the time he's a teenager," he
says.

By the numbers

54 percent of married women 40-44 years reported sterilization
operations in 2002.

51 percent of pregnancies among women 40 years and older are
unintended.

38 percent of women have experienced an unplanned birth by the
time they reached 40-44.